Skip to main content

Neighborhoods and Infectious Disease Risk: Acquisition of Chlamydia during the Transition to Young Adulthood

Abstract

Adolescents and young adults have the highest rates of sexually transmitted infections (STIs) in the USA despite national priority goals targeting their reduction. Research on the role of neighborhoods in shaping STI risk among youth has increased in recent years, but few studies have explored the longitudinal effects of neighborhoods on STI acquisition during the adolescent to young adult transition. The aims of this study were to examine: (1) the longitudinal relationships between the neighborhood context (poverty, residential instability, and racial/ethnic concentration) of exposure during adolescence and young adults’ acquisition of chlamydia, and (2) the extent to which sexual risk behaviors and depression over the transition from adolescence to young adulthood mediate the relationship between the neighborhood context of exposure during adolescence and young adults’ acquisition of chlamydia. A longitudinal observational design was employed using data from the National Longitudinal Study of Adolescent Health (Add Health), waves 1–3 (1994–2002). The sample was composed of 11,460 young adults aged 18 to 27 years. Neighborhood measures during adolescence were derived from the 1990 US Census appended to adolescents’ interview data. Chlamydia infection was measured via urine assay at wave 3 and 4.6 % of the young adults in the sample tested positive for chlamydia. Multilevel logistic regression analyses were conducted adjusting for numerous neighborhood and individual risk factors. Multivariate findings indicated exposure to neighborhood poverty during adolescence increased the likelihood of a positive urine test for chlamydia during young adulthood (AOR = 1.23, 95 % CI = 1.06, 1.42), and the association was not mediated by sexual risk behaviors or depression. Further research is needed to better understand the pathways through which exposure to neighborhood poverty contributes to chlamydia over the life course as are comprehensive STI prevention strategies addressing neighborhood poverty.

This is a preview of subscription content, access via your institution.

References

  1. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2010. Atlanta: U.S. Department of Health and Human Services; 2011.

  2. Healthy People 2010. Sexually transmitted infections. Available at: http://www.healthypeople.gov/2010/Document/HTML/Volume2/25STDs.htm Accessed May 5, 2012.

  3. Healthy People 2020. Sexually transmitted diseases. Available at: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=37 Accessed May 5, 2012.

  4. Shaw CR, McKay HD. Juvenile delinquency and urban areas. Chicago: The University of Chicago Press; 1969.

    Google Scholar 

  5. Sampson RJ, Raudenbush S, Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science. 1997; 277(5328): 918–24.

    CAS  PubMed  Article  Google Scholar 

  6. Wilson WJ. The truly disadvantaged: the inner city, the underclass, and public policy. Chicago: University of Chicago Press; 1987.

    Google Scholar 

  7. Krieger N, Waterman PD, Chen JT, et al. Monitoring socioeconomic inequalities in sexually transmitted infections, tuberculosis, and violence: geocoding and choice of area-based socioeconomic measures—the public health disparities geocoding project (US). Public Health Rep. 2003; 118: 240–60.

    PubMed Central  PubMed  Google Scholar 

  8. Cohen D, Spear S, Scribner R, et al. “Broken Windows” and the risk of gonorrhea. Am J Public Health. 2000; 90: 230–6.

    CAS  PubMed  Article  Google Scholar 

  9. Cohen DA, Mason K, Bedimo A, et al. Neighborhood physical conditions. Am J Public Health. 2003; 93: 467–71.

    PubMed  Article  Google Scholar 

  10. Du P, McNutt LA, O’Campo P, et al. Changes in community socioeconomic status and racial distribution associated with gonorrhea rates: an analysis at the community level. Sex Transm Dis. 2009; 36: 430–8.

    PubMed  Article  Google Scholar 

  11. Zierler S, Krieger N, Tang Y, et al. Economic deprivation and AIDS incidence in Massachusetts. Am J Public Health. 2000; 90: 1064–73.

    CAS  PubMed  Article  Google Scholar 

  12. Ford JL, Browning CR. Neighborhood social disorganization and the acquisition of trichomoniasis among young adults in the United States. Am J Public Health. 2011; 101: 1696–703.

    PubMed  Google Scholar 

  13. Biello KB, Pettigrew MM, Niccolai LM. Multiple chlamydia infection among young women: comparing the role of individual- and neighbourhood-level measures of socioeconomic status. Sex Transm Infect. 2011; 87: 560–2.

    PubMed Central  PubMed  Article  Google Scholar 

  14. Adimora AA, Schoenbach VJ. Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. J Infect Dis. 2005; 191(Suppl 1): S115–22.

    PubMed  Article  Google Scholar 

  15. Kaplan MS, Crespo CJ, Huguet N, Marks G. Ethnic/racial homogeneity and sexually transmitted disease: a study of 77 Chicago community areas. Sex Transm Dis. 2009; 36: 108–11.

    PubMed  Article  Google Scholar 

  16. Upchurch DM, Mason WM, Kusonoki Y, Kriechbaum MJ. Social and behavioral determinants of self-reported STD among adolescents. Perspect Sex Reprod Health. 2004; 36: 276–87.

    PubMed  Article  Google Scholar 

  17. Laumann EO, Youm Y. Racial/ethnic group differences in the prevalence of sexually transmitted diseases in the United States: a network explanation. Sex Transm Dis. 1999; 26: 250–61.

    CAS  PubMed  Article  Google Scholar 

  18. Diez Roux AV, Mair C. Neighborhoods and health. Ann N Y Acad Sci. 2010; 1186: 125–45.

    PubMed  Article  Google Scholar 

  19. Halfon N, Hochstein M. Life course health development: an integrated framework for developing health, policy, and research. Milbank Q. 2002; 80: 433–79.

    PubMed Central  PubMed  Article  Google Scholar 

  20. Browning CR, Burrington LA, Leventhal T, Brooks-Gunn J. Neighborhood structural inequality, collective efficacy, and sexual risk behavior among urban youth. J Health Soc Behav. 2008; 49(3): 269–85.

    PubMed Central  PubMed  Article  Google Scholar 

  21. Browning CR, Leventhal T, Brooks-Gunn J. Neighborhood context and racial differences in early adolescent sexual activity. Demography. 2004; 41(4): 697–720.

    PubMed  Article  Google Scholar 

  22. Browning CR, Olinger-Wilbon M. Neighborhood structural disadvantage, social organization, and number of short-term sexual partnerships. J Marriage Fam. 2003; 65: 730–45.

    Article  Google Scholar 

  23. Cubbin C, Brindis CD, Jain S, et al. Neighborhood poverty, aspirations and expectations, and initiation of sex. J Adolesc Health. 2010; 47: 399–406.

    PubMed  Article  Google Scholar 

  24. Aneshensel CS, Sucoff CA. The neighborhood context of adolescent mental health. J Health Soc Behav. 1996; 37: 293–310.

    CAS  PubMed  Article  Google Scholar 

  25. Dupéré V, Leventhal T, Lacourse É. Neighborhood poverty and suicidal thoughts and attempts in late adolescence. Psychol Med. 2009; 39: 1295–306.

    PubMed  Article  Google Scholar 

  26. Ford JL, Rechel M. Parental perceptions of the neighborhood context and adolescent depression. Public Health Nurs. 2012; 29: 390–402.

    PubMed  Article  Google Scholar 

  27. Khan MR, Kaufman JS, Pence BW, et al. Depression, sexually transmitted infection, and sexual risk behavior among young adults in the United States. Arch Pediatr Adolesc Med. 2009; 163: 644–52.

    PubMed Central  PubMed  Article  Google Scholar 

  28. Brawner BM, Gomes MM, Jemmott LS, Deatrick JA, Coleman CL. Clinical depression and HIV risk-related sexual behaviors among African-American adolescent females: unmasking the numbers. AIDS Care. 2012; 24: 618–25.

    CAS  PubMed  Article  Google Scholar 

  29. Harris KM. The National Longitudinal Study of Adolescent Health (Add Health), waves I and II, 1994–1996; wave III, 2001–2002; wave IV, 2007–2009 [machine-readable data file and documentation]. Chapel Hill, NC: Carolina Population Center, University of North Carolina at Chapel Hill; 2009.

  30. Harris KM, Halpern CT, Whitsel E, et al. The National Longitudinal Study of Adolescent Health: Research Design. Available at: http://www.cpc.unc.edu/projects/addhealth/design. Accessed March 15, 2012.

  31. Chantala K, KalsbeekWD, Andraca E. Non-response in wave III of the Add Health Study. Available at: http://www.cpc.unc.edu/projects/addhealth/data/guides/W3nonres.pdf. Accessed March 15, 2012.

  32. Schmitz, JL. Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) testing. In Biomarkers wave III of the Add Health study. Available at: http://www.cpc.unc.edu/projects/addhealth/data/using/guides/biomark.pdf. Accessed March 13, 2012.

  33. Burdette AM, Needham BL. Neighborhood environment and body mass index trajectories from adolescence to adulthood. J Adolesc Health. 2012; 50: 30–7.

    PubMed  Article  Google Scholar 

  34. Johnson RC, Schoeni RF. Early-life origins of adult disease: national longitudinal population-based study of the United States. Am J Public Health. 2011; 101: 2317–24.

    PubMed  Article  Google Scholar 

  35. Acevedo-Garcia D, Lochner KA. Residential segregation and health. In: Kawachi I, Berkman LF, eds. Neighborhoods and Health. New York: Oxford; 2003: 265–87.

    Chapter  Google Scholar 

  36. Wodtke GT, Harding DJ, Elwert F. Neighborhood effects in temporal perspective. Am Sociol Rev. 2011; 76: 713–36.

    PubMed Central  PubMed  Article  Google Scholar 

  37. Beretvas SN. Cross-classified and multiple-membership models. In: Hox J, Roberts JK, eds. Handbook of advanced multilevel analysis. London: Routledge Academic; 2010: 313–34.

    Google Scholar 

  38. Naess O, Leyland AH. Analysing the effect of area of residence over the life course in multilevel epidemiology. Scand J Public Health. 2010; 38(5 Suppl): 119–26.

    PubMed  Article  Google Scholar 

  39. Bearman PS, Moody J, Stovel K. Chains of affection: the structure of adolescent romantic and sexual networks. AJS. 2004; 110: 44–91.

    Google Scholar 

  40. Aiello AE, Simanek AM, Galea S. Population levels of psychological stress, herpesvirus reactivation and HIV. AIDS Behav. 2010; 14: 308–17.

    PubMed  Article  Google Scholar 

  41. Pedersen AF, Bovbjerg DH, Zachariae R. Stress and susceptibility to infectious disease. In: The handbook of stress science: biology, psychology, and health (Eds. Contrada RJ, Baum A). 2011. New York: Springer. 425–446.

  42. Petersen KL, Marsland AL, Flory J, Votruba-Drzal E, Muldoon MF, Manuck SB. Community socioeconomic status is associated with circulating interleukin-6 and c-reactive protein. Psychosom Med. 2008; 70: 646–52.

    CAS  PubMed  Article  Google Scholar 

  43. Nazmi A, Diez Roux A, Ranjit N, Seeman TE, Jenny NS. Cross-sectional and longitudinal associations of neighborhood characteristics with inflammatory markers: findings from the multi-ethnic study of atherosclerosis. Health Place. 2010; 16: 1104–12.

    PubMed Central  PubMed  Article  Google Scholar 

  44. Browning CR, Cagney KA, Iveniuk J. Neighborhood stressors and cardiovascular health: crime and C-reactive protein in Dallas, USA. Soc Sci Med. 2012; 75: 1271–9.

    PubMed  Article  Google Scholar 

  45. Do DP, Diez Roux AV, Hajat A, et al. Circadian rhythm of cortisol and neighborhood characteristics in a population-based sample: the multi-ethnic study of atherosclerosis. Health Place. 2011; 17: 625–32.

    PubMed Central  PubMed  Article  Google Scholar 

  46. Karb RA, Elliott MR, Dowd JB, Morenoff JD. Neighborhood-level stressors, social support, and diurnal patterns of cortisol: the Chicago community adult health study. Soc Sci Med. 2012; 75: 1038–47.

    PubMed Central  PubMed  Article  Google Scholar 

Download references

Acknowledgments

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis.

Funding

This study was funded by the Robert Wood Johnson Foundation Nurse Faculty Scholar program awarded to the first author.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jodi L. Ford.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ford, J.L., Browning, C.R. Neighborhoods and Infectious Disease Risk: Acquisition of Chlamydia during the Transition to Young Adulthood. J Urban Health 91, 136–150 (2014). https://doi.org/10.1007/s11524-013-9792-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-013-9792-0

Keywords

  • Neighborhood
  • Chlamydia
  • Sexually transmitted infection
  • Life course